Cegema
Cegema is a French delegated administrator that manages health, provident, and borrower insurance contracts for 200,000 insured lives on behalf of insurance carriers, corporate HR departments, brokers, and individual policyholders, operating as a wholly-owned subsidiary of the Kereis group.
- Company typePrivate
- Founded1990
- HeadquartersVilleneuve-loubet, France
- Headcount101–250
- GTM typeB2B
- OfferingServices
What Cegema does
Cegema is a French delegated administrator (délégataire de gestion) specializing in the end-to-end management of health and provident insurance contracts, serving as an outsourced operations partner to insurance carriers, corporate HR departments, insurance brokers, and individual policyholders. Founded in 1990 and headquartered in Villeneuve-Loubet in the Alpes-Maritimes, the company protects approximately 200,000 insured lives, processes €133 million in annual premium contributions, and pays out €100 million in reimbursements annually. Cegema employs 120-180 staff, including 100+ dedicated health insurance experts and 20+ provident insurance experts, and is registered with ORIAS (n° 07 001 328) under ACPR supervision. Since November 2022, Cegema has operated as a wholly-owned subsidiary of the Kereis group, a French insurance brokerage group with 1,700 employees across seven European countries.
The company's product portfolio spans three core service lines: health insurance contract management (gestion de contrat santé), provident insurance contract management (gestion de contrat prévoyance), and since 2021, delegated borrower insurance (assurance emprunteur) deployed with Swiss Life. Distribution is delivered through three role-based digital portals — Espace Assuré for individual policyholders, Espace RH for corporate HR departments, and Cegecour for insurance brokers — supplemented by two mobile applications on iOS and Android. Core technology capabilities include automated DSN (Déclaration Sociale Nominative) processing, Noémie tele-transmission integration (93% connection rate), OCR-based document recognition for photo-submitted claims, AI-powered fraud detection via a partnership with Shift Technology, and a tiers payant (third-party payment) network of 230,000 contracted healthcare professionals managed through iSanté. Operational performance metrics include 90% of reimbursements processed within 24 hours and a >90% customer service call answer rate.
Cegema generates revenue through management fees earned from insurance carriers for delegated administration services across health, provident, and borrower insurance contracts, with no publicly disclosed pricing tiers. Pricing is negotiated on a per-contract basis with carriers and corporate clients. The go-to-market combines self-serve digital portals (PLG) for individual policyholders and employees, enterprise field sales with dedicated account management for HR departments, and channel-partner relationships with insurance brokers via Cegecour and dedicated commercial support. The company completed a major transformation in 2025 encompassing an information system overhaul, deployment of new digital tools, and a refreshed brand identity, positioning the business for continued operational modernization under Kereis group ownership.
Cegema firmographics
Firmographics- Name
- Cegema
- Legal name
- CEGEMA
- Website
- https://cegema.com
- Company type
- Private
- Founded year
- 1990
- Operating status
- Operating
- Headcount range
- 101–250 employees
- Short description
- Cegema is a French delegated administrator that manages health, provident, and borrower insurance contracts for 200,000 insured lives on behalf of insurance carriers, corporate HR departments, brokers, and individual policyholders, operating as a wholly-owned subsidiary of the Kereis group.
- Ownership category
- akta.pro rank
Cegema industry classification
Industry- Product category
- Health and Provident Insurance Administration
- NAICS
- Other Insurance Related Activities (52429), Claims Adjusting (524291), Agencies, Brokerages, and Other Insurance Related Activities (5242)
- SIC
- Hospital & Medical Service Plans (6324), Insurance Agents, Brokers & Service (6411)
- akta.pro primary industry
- COBRA & Direct Billing Administration (HLAEALAC)
- akta.pro secondary industry
- Utilization Management (Prior Auth/Medical Necessity) Administration (HLAEALAF)
Keywords
Where Cegema is headquartered
LocationHeadquarters
- HQ city
- Villeneuve-loubet
- HQ country
- France
- HQ region
- Europe
Offices1 record
Markets served
Cegema business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Infrastructure, Marketing or Sales, Others
Revenue model
- Health Insurance Management Fees: Cegema acts as a third-party administrator (gestionnaire) for health insurance contracts, earning management fees from insurance carriers for processing reimbursements, handling memberships, and providing customer service to policyholders. The company processes 133M euros in contributions and 100M euros in reimbursements annually.
- Provident Insurance Management Fees: Cegema manages individual and collective provident insurance contracts (death, disability, incapacity), earning fees from insurers for claims processing, policy administration, and medical management. Active since 2014.
- Borrower Insurance (Emprunteur) Management: Cegema provides delegated management services for borrower insurance launched in 2021 and deployed with Swiss Life, earning fees from the insurance carrier for processing credit-related insurance claims.
Go-to-market motion3 records
Distribution channels4 records
Marketing channels4 records
Cegema product offering
Product offeringCore offering
Cegema is a French delegated insurance administrator (gestionnaire délégataire) that designs, manages, and administers health and provident insurance contracts on behalf of insurance carriers, enterprises, and brokers. The company handles policy subscription, contributions collection, claims reimbursement, third-party payment agreements with healthcare providers, and provides digital self-service portals and mobile applications to policyholders, employees, and HR departments. It also administers borrower insurance (Assurance Emprunteur) and offers accelerated daily allowance (Prest'IJ) services.
Product overview
Cegema offers a unified insurance contract management platform for health and provident insurance, consisting of three primary digital portals (Espace Assuré for policyholders, Espace RH for employers, and Cegecour for insurance brokers) supported by two dedicated mobile applications (Espace Particulier and Espace Salarié). The service modules include Tiers payant iSanté for third-party payment processing, Gestion de contrat santé for health insurance management, Gestion de contrat prévoyance for provident coverage, and Prest'IJ for accelerated daily allowance processing. The platform also features specialized tools like online hospitalization pre-authorization and AI-powered fraud detection to support the complete insurance management lifecycle from enrollment through claims reimbursement.
Differentiator
Problem solved
Functional benefit
Products and services
- Health Insurance Contract Administration (Gestion de contrat santé)
Quantifiable outcome
- 90% of reimbursements processed within 24 hours
- +4 more outcomes
Companies that use Cegema
Customer profileNamed customers4 records
Segments3 records
Ideal customer profiles3 records
Cegema technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration4 records
AI capability2 records
Feature7 records
Cegema partnerships and signals
Strategic signalPartnerships
Two partnerships are on record, tiered core.
- Swiss LifecoreSwiss Life partnered with Cegema in 2022 to deploy borrower insurance (assurance emprunteur) management services. Cegema acts as delegated administrator for Swiss Life's borrower insurance products, handling policy administration and claims processing for credit-related insurance.
- iSantécoreiSanté manages the tiers payant (third-party payment) network for Cegema. Healthcare professionals submit take-charge requests directly to iSanté. iSanté provides the infrastructure for the 230,000-contracted-professional network that enables policyholders to avoid advance payment of medical expenses.
Scale indicators10 records
Recent moves9 records
Expansion highlights6 records
Cegema competitors and assessment
Company assessmentBroad incumbents
- AXA France: Largest French multi-line insurer with group health, provident, and retirement products distributed through brokers and direct channels. Broad incumbent rather than delegated-administration specialist, but overlapping product lines and a potential carrier client for Cegema-style services.
- Malakoff Humanis: Major French social protection group providing health and provident insurance, retirement, and savings. Overlaps with Cegema in employer-sponsored health/provident administration but operates at much greater scale as a multi-line social protection platform.
- Vyv (Harmonie Mutuelle): Major French mutual health insurance group combining a mutuelle with delegated services and a digital health ecosystem. Larger and broader than Cegema, but overlapping health-administration capabilities and distribution through brokers and employers.
- Generali France: Major French multi-line insurer with health, provident, life, and P&C offerings through a broker-led distribution model. Comparable product surface but a broad incumbent rather than a dedicated delegated administrator.
- Swiss Life France: Major French health/provident insurer and Cegema's anchor borrower-insurance delegated-administration partner. Broader portfolio but comparable product surface; a key client-distribution counterparty for Cegema.
- Groupama: French mutual insurer with extensive health, provident, and property-casualty lines, primarily via regional mutuals. Overlaps with Cegema in employer-sponsored health/provident and broker distribution but operates a much broader insurance franchise.
Direct peers
- Almerys: French third-party health insurance administrator focused on claims processing, reimbursement flows, and digital tools for policyholders. Overlaps directly with Cegema on TPA services, reimbursement processing, and digital portal/ecosystem delivery to French insurance carriers.
- Henner: Major French delegated manager for group health, provident, and retirement insurance. Direct comparable: both act as third-party administrators managing reimbursements, affiliations, and broker/HR portals for insurers and employers in France.
- SPVIE: French delegated administrator of health and provident insurance contracts serving brokers, insurers, and policyholders. Operates the same delegated-management business model as Cegema, processing reimbursements and managing individual and collective contracts.
Regional players
- Pro BTP: French social protection group dedicated to construction-sector employees, operating its own health and provident plans with in-house delegated management. Comparable TPA-style business model but specialized to a single industry segment.
Market position
Strengths5 records
Weaknesses6 records
Competitive moat6 records
Key risks6 records
Key highlights6 records
Customer concentration
Cegema social profiles
Digital presenceCegema compliance and trust
Trust signalCompliance3 records
Cegema financial estimates
Financial estimateRevenue estimate
Valuation estimate
Cegema leadership team
Management profileNumber of profiles
Profiles1 record
Cegema funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Cegema M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Cegema
What does Cegema do?
Cegema is a French delegated insurance administrator (gestionnaire délégataire) that designs, manages, and administers health and provident insurance contracts on behalf of insurance carriers, enterprises, and brokers. The company handles policy subscription, contributions collection, claims reimbursement, third-party payment agreements with healthcare providers, and provides digital self-service portals and mobile applications to policyholders, employees, and HR departments. It also administers borrower insurance (Assurance Emprunteur) and offers accelerated daily allowance (Prest'IJ) services.
Is Cegema a public or private company?
Cegema is a private company. It is classified as corporate owned and is currently operating.
When was Cegema founded?
Cegema was founded in 1990. It employs 101 to 250 people.
Where is Cegema based?
Cegema is headquartered in Villeneuve-loubet, France, in the Europe region.
How does Cegema make money?
Three revenue lines are on record. Health Insurance Management Fees are the primary driver. The others are provident Insurance Management Fees and borrower Insurance (Emprunteur) Management.
Who are Cegema's main competitors?
Broad incumbents on record are AXA France, Malakoff Humanis, Vyv (Harmonie Mutuelle), Generali France, Swiss Life France and Groupama. Direct peers are Almerys, Henner and SPVIE. Pro BTP is listed as a regional player.
Does Cegema have an API?
No public API is recorded for Cegema.
What industry is Cegema in?
Cegema's product category is Health and Provident Insurance Administration. Its primary akta.pro industry code is HLAEALAC, COBRA & Direct Billing Administration, with a secondary code of HLAEALAF, Utilization Management (Prior Auth/Medical Necessity) Administration. Its NAICS code is 52429 and its SIC code is 6324.